Eighty-seven percent of strokes are ischemic, meaning they are caused by clots that block blood flow to a portion of the brain. In selected patients, stent retrievers can be used to remove such clots.
A stent retriever is a self-expanding mesh tube attached to a wire, which is guided through a catheter (thin tube). The endovascular specialist inserts the catheter in an artery in the groin and guides the catheter through various blood vessels all the way up to the brain.
Once the stent retriever reaches the blockage, the endovascular specialist deploys it. The device pushes the gelatinous blood clot against the wall of the blood vessel, immediately restoring blood flow. The stent retriever then is used to grab the clot, which is pulled out when the surgeon removes the catheter.
"With the advent of stent retriever devices, there has been a paradigm shift in the utilization of endovascular therapies for acute ischemic stroke," Drs. Gill and Schneck write.
Recent trials of stent retrievers consistently show the newer devices are clearly superior to the intravenous drug tissue plasminogen activator (tPA) alone in reducing disability from strokes.
Drs. Gill and Schneck foresee future device improvements that will do an even better job of restoring blood flow and increasing the number of patients who could benefit.
Loyola University Health System